A judge's ruling allows nearly all of North Carolina's revised 12-week abortion law to take effect

A federal judge ruled on Friday that nearly all of North Carolina's revised 12-week abortion law scheduled to begin this weekend can take effect, while temporarily blocking one rule that doctors feared could expose them to criminal penalties.

The decision by U.S. District Judge Catherine Eagles sets aside that rule but allows the law's remaining provisions to begin on Saturday while litigation continues.

Abortion providers had last week requested a blanket order halting all of the July 1 restrictions pending their court challenge. Planned Parenthood South Atlantic and a physician said several sections in the newly revised law were so vague and seemingly contradictory that doctors could unintentionally break the law, leaving them unable to care for women seeking legal abortions.

But the Republican-controlled General Assembly passed legislation this week revising or repealing nearly all of the challenged provisions, making arguments against most of them moot. Among other things, the lawmakers clarified that medication abortions will be legal in nearly all cases through 12 weeks, and that a lawful abortion remains an exception to North Carolina’s fetal homicide statute.

Eagles, who was nominated by former President Barack Obama, had said in court that it would be overly broad to block enforcement of the entire law. Instead, she directed that for at least the next two weeks, the state cannot enforce a rule saying doctors must document the existence of a pregnancy within the uterus before conducting a medication abortion.

The abortion providers' lawyers argued that the language raised questions about whether abortion pills can be dispensed when it's too early in a pregnancy to locate an embryo using an ultrasound — subjecting a provider to potentially violating the law.

“If the pregnancy is in early stages and the physician cannot document the existence of an intrauterine pregnancy, then the physician cannot comply with this requirement,” Eagles wrote. She said she’ll revisit the rule as well as other challenges in upcoming hearings.

Peter Im, a Planned Parenthood attorney, said the plaintiffs had already received much of what they had sought in the lawsuit through the legislature's revisions. And now with Eagles' order, “it is clear that we can provide care to patients at the very earliest stages of pregnancy,” Im said.

Lauren Horsch, a spokesperson for Senate leader Phil Berger, said that “the General Assembly provided the clarity physicians asked for.”

Before Saturday, North Carolina has had a ban on most abortions after 20 weeks. The new rules, developed after the U.S. Supreme Court in June 2022 struck down Roe v. Wade, reduce it to 12 weeks, but add new exceptions through 20 weeks for cases of rape and incest and through 24 weeks for “life-limiting” fetal anomalies. A medical emergency exception also remains in place.

Democratic Gov. Roy Cooper vetoed the abortion law in May, but Republicans overrode him using their veto-proof GOP majorities in both chambers. Cooper then signed on Thursday the clean-up bill, which had overwhelming bipartisan support. Although a strong abortion-rights supporter, Cooper said it was important to clarify the rules because the original measure was “so poorly written that it is causing real uncertainty for doctors and other health care providers.”

GOP legislators backing the new restrictions called them a middle-ground change in a state where some anti-abortion advocates wanted a ban imposed as soon as an ultrasound can detect cardiac activity, or around six weeks. They also pointed to $160 million contained in the law for services benefitting children and families.

Caitlin Connors with the anti-abortion group SBA Pro-Life America said Friday’s ruling was “a crucial win for the unborn and their mothers.”

Critics say the 12-week standard, along with new restrictions on providers, abortion clinics and patients, will make it harder for low-income women and those in rural areas to obtain lawful abortions. They point in part to a requirement that someone seeking an abortion must visit a provider’s office in person before the state’s 72-hour waiting period — already in place for years — can begin. Before, that initial contact could be done over the phone.

Broadly, the new restrictions will “absolutely harm patients. Our patients are devastated and the doctors who care for them are devastated,” Dr. Katherine Farris, Planned Parenthood South Atlantic's chief medical officer, told reporters Friday. This week, the group "had to start navigating patients out of state, knowing that they would not be eligible for care” starting Saturday, she added.

The new abortion law also says that starting Oct. 1, surgical abortions — also known as procedural abortions — performed after 12 weeks of pregnancy must be completed in hospitals. The lawsuit still challenges that requirement. New licensing of abortion clinics also is slated to begin in October.